Active NPI
Dena Boyd
- Professional Counselor
- Farmington, MO
National Provider Identifier
1083162218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2016031789
- Practice address
- 400 N Washington St
Suite 116
Farmington, MO 63640-1716 - Phone
- (573) 218-9653
- Fax
- (573) 803-1405
- NPI assigned
- Sep 16, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2016031789 | MO | Primary |
Addresses
Primary practice location
400 N Washington St
Suite 116
Farmington, MO 63640-1716
Mailing address
400 N Washington St
Suite 116
Farmington, MO 63640-1716
Phone (573) 218-9653
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016031789 | MO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tender Hearts Child Therapy Center, LLC | Professional | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Tender Hearts Child Therapy Center
- Professional Counselor
- Cape Girardeau, MO
- NPI 1568777910
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473984000000",
"number": "1083162218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 N WASHINGTON ST",
"address_2": "SUITE 116",
"city": "FARMINGTON",
"state": "MO",
"postal_code": "636401716",
"telephone_number": "573-218-9653",
"fax_number": "573-803-1405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N WASHINGTON ST",
"address_2": "SUITE 116",
"city": "FARMINGTON",
"state": "MO",
"postal_code": "636401716",
"telephone_number": "573-218-9653",
"fax_number": "573-803-1405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYD",
"first_name": "DENA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-16",
"last_updated": "2016-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2016031789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.